Effects of Dexmedetomidine Nasal Sprays on Postoperative Sleep Quality in Patients Who Underwent Laparoscopic Gynaecological Surgery: A Single-Centre, Double-Blind, Randomized Controlled Study

Abstract

Background: Dexmedetomidine nasal sprays is effective for perioperative sedation, analgesia, and anxiolysis. Nevertheless, its impact on postoperative sleep quality along with the optimal dosage and overall efficacy remains unclear in patients undergoing laparoscopic gynecological surgery. Methods: A total of 150 adult patients undergoing laparoscopic gynecological surgery were enrolled, with 144 included in the final analysis. Patients in the dexmedetomidine (Dex) group received 50 µg of intranasal dexmedetomidine 30 minutes before sleep on the first postoperative night, while the control group received an equivalent volume of saline. Primary outcomes included objective sleep parameters (sleep duration, deep sleep duration, REM sleep duration and light sleep duration) measured via a portable sleep monitor, as well as subjective sleep parameters assessed by Athens Insomnia Scale (AIS) and Numerical Rating Scale (NRS) scores one night before and on the first night after surgery. Secondary outcomes comprised postoperative pain measured by VAS, nausea and vomiting, and average heart rate. Results: The sleep duration, deep sleep duration and REM sleep duration of patients in the control group decreased after laparoscopic gynaecological surgery (vs preoperative control group, P=0.021, P<0.001, P=0.005, respectively), whereas the fragmented sleep duration and NRS score increased (vs preoperative control group, P=0.017, P=0.032, respectively). In contrast, those treated with dexmedetomidine (Dex group) exhibited significantly improved sleep quality postoperatively, with greater sleep duration, deep sleep duration, and REM sleep durations (vs control group, P<0.001, P<0.001, P<0.001, respectively). There were no significant differences in postoperative pain or nausea and vomiting between the two groups. Conclusion: Dexmedetomidine nasal sprays improved postoperative sleep quality in patients who underwent laparoscopic gynaecological surgery. Trial Registration: Chinese Clinical Trial Registry (clinical trial number: ChiCTR2400080181).